Orthopedic Plate Assembly for a Distal Radius Having Re-Contouring Features and Method for Using Same

ABSTRACT

An orthopedic plate assembly for supporting a bone can include a y-shaped first plate and a second plate separate from the first plate. The first plate can be attached to the bone and have a center line. The first plate can include an elongate body attachable to a first portion of the bone and extending along the center line and first and second arms transversely extending from an end of the body. The first and second arms can define an aperture in the first plate. The second plate can be attached to the bone. The second plate can have a first end and a second end opposite the first end configured to be disposed on and engaged with the first arm and the second arm, respectively. The second plate can be configured to span the aperture transverse to the center line when engaged with the first and second arms.

FIELD

The present disclosure relates to orthopedic plates used to treat afractured radius, and more particularly, to orthopedic plates that canbe contoured to match the external surface of the radius.

BACKGROUND

This section provides background information related to the presentdisclosure which is not necessarily prior art.

Bones can become fractured due to high impact or stress, or as a resultof a medical condition that weakens the bones, such as osteoporosis. Forexample, the force of a fall on an outstretched hand can result in adistal radius fracture. Incomplete fractures are fractures in which bonefragments are still partially joined, while complete fractures arefractures in which the bone fragments are completely separated.Depending on the severity, treatment of fractured bones can includealigning the bone fragments to their natural positions, calledreduction, and maintaining the natural positions while the bones heal,called immobilization.

Immobilization can be achieved using non-operative procedures and/orsurgical procedures. In non-operative procedures, casts, splints, orother external fixation devices can maintain the natural positions byimmobilizing joints above and below the fractured bone. When treatedthrough surgery, orthopedic nails, screws, plates, and wires can holdthe bone fragments together more directly. Orthopedic platesapproximating the contour of the fractured bone can attach to the bonefragments and fix the bone fragments in their natural positions.However, due to variation in the contour of bones and variation infracture patterns, orthopedic plates having improved contouringcapability are desired. Through improved contouring, the bone fragmentscan be fixed in positions more closely matching their natural positions.

SUMMARY

This section provides a general summary of the disclosure, and is not acomprehensive disclosure of its full scope or all of its features.

An orthopedic plate assembly for supporting a bone can include ay-shaped first plate and a second plate separate from the first plate.The first plate can be attachable to the bone and have a center line.The first plate can include an elongate body attachable to a firstportion of the bone and extending along the center line, a first armtransversely extending from an end of the body, and a second armtransversely extending from the end of the body. The first and secondarms can define an aperture in the first plate.

The second plate can be attachable to the bone. The second plate canhave a first end configured to be disposed on and engaged with the firstarm, and a second end opposite the first end configured to be disposedon and engaged with the second arm. The second plate can be configuredto span the aperture transverse to the center line when engaged with thefirst and second arms.

An orthopedic plate assembly for supporting a fractured radius caninclude a first plate, a second plate separate from the first plate, anda first engagement member. The first plate can be attachable to a firstbone fragment and a second bone fragment of the radius and have acenterline. The first plate can include an elongate body attachable tothe first fragment and extending along the center line, a first armtransversely extending from an end of the body, and a second armtransversely extending from the end of the body. The second plate caninclude a first transverse surface on a first end engageable with asecond transverse surface of the first arm, and a third transversesurface on a second end opposite the first end engageable with a fourthtransverse surface of the second arm. The second plate can be configuredto span the aperture transverse to the center line when engaged with thefirst and second arms.

The first engagement member can be configured to constrain relativetranslational movement between the first and second plates in at leasttwo perpendicular directions when engaged. The first engagement membercan include a first bearing component coupled to the first transversesurface of the second plate, and a second bearing component coupled tothe second transverse surface of the first arm and directly engageablewith the first bearing component.

A method for supporting a fractured radius using an orthopedic plateassembly can include exposing the radius, selecting a first plate andselectively re-contouring the first plate, and attaching the first plateto a first portion of the radius using a first attachment device. Thefirst plate can have a center line and include a body extending alongthe center line, a first arm transversely extending from an end of thebody and including a first transverse surface, and a second armtransversely extending from the end of the body and including a secondtransverse surface. The first and second arms can define an aperture inthe first plate.

The method can further include selecting a second plate and selectivelyre-contouring the second plate. The second plate can have a first endincluding a third transverse surface engageable with the firsttransverse surface of the first arm, and a second end opposite the firstend including a fourth transverse surface engageable with the secondtransverse surface of the second arm. The method can further includeengaging the second plate with the first plate at a predeterminedlongitudinal position within the aperture by engaging the third andfourth transverse surfaces of the second plate with the first and secondtransverse surfaces of the second plate, respectively. The method canfurther include attaching the second plate to at least one of the firstplate and a second portion of the radius.

Further areas of applicability will become apparent from the descriptionprovided herein. The description and specific examples in this summaryare intended for purposes of illustration only and are not intended tolimit the scope of the present teachings.

DRAWINGS

The drawings described herein are for illustrative purposes only ofselected examples and not all possible implementations, and are notintended to limit the scope of the present teachings.

FIG. 1 is an environmental illustration of an orthopedic plate assemblyaccording to the present disclosure coupled to a distal radius;

FIG. 2 is an exploded perspective view of the plate assembly of FIG. 1;

FIG. 3 is a top view of the plate assembly of FIG. 1;

FIG. 4 is a cross-sectional side view of the plate assembly of FIG. 1taken along line 4-4;

FIG. 5 is a cross-sectional side view of the plate assembly of FIG. 1taken along line 5-5;

FIG. 6 is an exploded perspective view of another orthopedic plateassembly according to the present disclosure;

FIG. 7 is a top view of the plate assembly of FIG. 6;

FIG. 8 is a cross-sectional side view of a portion of the plate assemblyof FIG. 6 taken along line 8-8;

FIG. 9 is a cross-sectional side view of the plate assembly of FIG. 6taken along line 9-9; and

FIG. 10 is a top view of a portion of another orthopedic plate assemblyaccording to the present disclosure.

Corresponding reference numerals indicate corresponding parts throughoutthe several views of the drawings.

DESCRIPTION OF VARIOUS EMBODIMENTS

Examples according to the present teachings will now be described morefully with reference to the accompanying drawings. The examples areprovided so that this disclosure will be thorough, and will fully conveythe scope to those who are skilled in the art. Numerous specific detailsare set forth such as examples of specific components, devices, andmethods, to provide a thorough understanding of the present teachings.It will be apparent to those skilled in the art that specific detailsneed not be employed, that examples may be embodied in many differentforms and that neither should be construed to limit the scope of thedisclosure. In some examples, well-known processes, well-known devicestructures, and well-known technologies are not described in detail.

With reference to FIGS. 1-5, an exemplary orthopedic plate assembly 10for internal fixation of two or more fragments 12, 14 of a fracturedbone 16 is presented. For clarity, various features of the plateassembly 10 will be described with reference to coordinate axes shown inFIG. 2. The plate assembly 10 can be used in a bone plate system usedfor internal fixation of the fragments 12, 14. In the present example,the plate assembly 10 is configured to attach to the distal, volaraspect of a fractured radius of a right arm. Although not specificallyshown, it will be appreciated that the plate assembly 10 can beconfigured, for example in a mirror image, to attach to a radius of aleft arm. It will be further appreciated that the present teachingsapply equally to orthopedic plates for attachment with other bones.

The plate assembly 10 can be secured to the bone 16, and moreparticularly, to each of the fragments 12, 14, using various attachmentdevices. Suitable attachment devices include, but are not limited to,orthopedic nails, bone screws, and k-wires. For example, the plateassembly 10 can be secured to the bone 16 using a combination of bonescrews 18 as shown (FIG. 1).

Generally, the plate assembly 10 can include a Y-shaped, bifurcatedplate member 20 and a support member 22, each having a plurality ofholes 24 configured to receive various attachment devices, such as thebone screws 18. The plate member 20 and the support member 22 can beindependently re-contoured and attached to the bone 16 using the holes24 and various attachment devices. In an exemplary surgical procedure,the plate member 20 can be attached to one or both the fragments 12, 14.Subsequently, the support member 22 can be attached to the plate member20 and/or at least one of the fragments 12, 14. When attached, thesupport member 22 can engage the plate member 20. Through engagement,the support member 22 can assist the plate member 20 in holding thefragments 12, 14 at or near their natural positions by assisting theplate member 20 in retaining a desired shape.

In various implementations, the plate assembly 10 can include a firstengagement member 26 and a second engagement member 28 at interfacesbetween the plate member 20 and the support member 22. The first andsecond engagement members 26, 28 can cooperate and thereby form jointsbetween the plate member 20 and the support member 22. The joints,discussed in more detail below, can constrain relative translationalmovement between the plate member 20 and the support member 22 andthereby assist the plate member 20 in retaining the desired shape.

The support member 22 and the plate member 20 can be formed to bemalleable or bendable, yet exhibit sufficient stiffness to support thebone 16 in their respective re-contoured shapes. The plate member 20 andthe support member 22 can include contouring regions including featuresthat enable the independent re-contouring of the plate member 20 and thesupport member 22 prior to and/or during the surgical procedure. Throughre-contouring, the shapes of the plate member 20 and the support member22 can be adjusted to more closely match the unique contour of the bone16 of a particular patient. Re-contouring can also be used to modify thetrajectories of one or more of the bone screws 18. Through engagement,the support member 22 and the plate member 20 can cooperate to increasethe stiffness of the overall plate assembly 10, and thereby assist inthe retention of the re-contoured shapes.

The plate member 20 and the support member 22 can be composed of variousbiocompatible materials of a suitable modulus of elasticity forproviding the plate member 20 and the support member with there-contouring and shape retention features. Suitable materials include,but are not limited to, biocompatible metals including stainless steel,titanium, and titanium-based alloys. The plate member 20 and the supportmember 22 can be formed using various manufacturing methods including,but not limited to, casting, machining, and forging.

The plate member 20 can generally be smooth and thin and can have alength along a center line 30. In FIGS. 1-5, the center line 30 is shownto extend along the x-axis. The plate member 20 can be formed to have apre-contoured shape based on a typical morphology of the bone to whichthe plate member 20 is to be secured. Generally, the plate member 20 caninclude a bone engaging surface 32, an outer surface 34, an aperture 36,and a predetermined number and arrangement of the holes 24.

The plate member 20 can have a thickness between the bone engagingsurface 32 and the outer surface 34. The thickness can vary along thelength to provide the plate member 20 with regions of varyingmalleability and can depend on the surrounding anatomy. For example, thethickness can taper to provide the plate member 20 with progressivelymore malleability from one end to an opposite end. The thickness canfurther vary to provide the plate member 20 with a low profile thatenables the plate member 20 to be positioned between various structuresof the anatomy such as, for example, between the bone 16 and tendons ofthe surrounding anatomy. According to the present example, the thicknesscan taper from a first thickness of around 3.0 millimeters (mm) on oneend (e.g., a proximal end) to a second thickness of around 2.0 mm on anopposite (e.g., distal end) as shown.

The plate member 20 can further include an elongated body 40, a firstarm 42, a second arm 44, a first tab 46, and a second tab 48 that areformed to provide the plate member 20 with a y-shape. The body 40 caninclude a first contouring region 50. The first and second arms 42, 44can include second and third contouring regions 52 a, 52 b,respectively. The first and second tabs 46, 48 can include fourth andfifth contouring regions 54 a, 54 b, respectively. The first contouringregion 50 can share boundaries 56 a, 56 b with the second and thirdcontouring regions 52 a, 52 b, respectively. The second and thirdcontouring regions 52 a, 52 b can share boundaries 58 a, 58 b with thefourth and fifth contouring regions 54 a, 54 b, respectively.

The bone engaging surface 32 can be a first major surface configured todirectly engage the bone 16. The outer surface 34 can be a second majorsurface opposite the bone engaging surface 32 and can be configured toallow the tendons of the surrounding anatomy to glide smoothly over theplate member 20 during implantation and post-surgery. For example, theouter surface 34 can generally be a smooth surface having chamferededges. In FIGS. 1-5, the bone engaging surface 32 and the outer surface34 are shown as including substantially planar surfaces for simplicity.It will be appreciated that the bone engaging surface 32 and the outersurface 34 can include other contoured surfaces. The bone engagingsurface 32 and the outer surface 34 can be further configured to inhibittissue adhesion with the plate member 20. In an exemplaryimplementation, the bone engaging surface 32 and the outer surface 34can be polished and/or anodized surfaces.

The outer surface 34 can define a rectangular first recess 60 having afirst bottom surface 62, and a rectangular second recess 64 having asecond bottom surface 66. The bottom surfaces 62, 66 can extendtransverse to the center line 30. The first recess 60 can be formed inthe first arm 42 and can nestingly receive one end of the support member22. The second recess 64 can be formed in the second arm 44 and cannestingly receive an opposite end of the support member 22. The firstand second recesses 60, 64 can be sized to provide gaps 68, 70 betweenthe support member 22 and the plate member 20, when engaged with oneanother. The gaps 68, 70 can be sized to accommodate variation in therelative positions of the plate member 20 and the support member 22 dueto re-contouring. The first and second recesses 60, 64 can be furthersized to allow an outer surface 72 of the support member 22 to liegenerally flush or co-planar with an adjoining portion of the outersurface 34 when the support member 22 is engaged with the plate member20.

The first and second bottom surfaces 62, 66 can be disposed between thebone engaging surface 32 and the outer surface 34. The first and secondbottom surfaces 62, 66 can engage an inner surface 74 of the supportmember 22 that faces the outer surface 34 when the support member 22 isengaged with the plate member 20. The first and second bottom surfaces62, 66 can directly engage the inner surface 74. Alternatively, oradditionally, the first and second bottom surfaces 62, 66 can engage thesupport member 22 via the first and second engagement members 26, 28, asillustrated by the present example. The first and second bottom surfaces62, 66 can form a portion of the first and second engagement members 26,28.

Generally, the aperture 36 can extend between the first and second arms42, 44 and can be triangularly shaped. The aperture 36 can provideaccess for viewing the fracture site and/or applying a bone graft orother biologic material during the surgical procedure, when the platemember 20 is secured to the bone 16. The aperture 36 can be sized anddisposed at a predetermined location of the plate member 20. The sizeand location can be predetermined based on the morphology of the bone 16and the associated fracture patterns.

The holes 24 included with the plate member 20 can be configured toreceive the various attachment devices used to secure the plate member20 to the bone 16. Accordingly, the holes 24 can extend through theouter surface 34 and the bone engaging surface 32, and can be of varioussizes and configurations. The holes 24 can have a predetermined numberand predetermined arrangement based on typical fracture patterns of thebone 16. The holes 24 can provide predetermined trajectories ortrajectory ranges for the attachment devices. Through re-contouring ofthe plate member 20, the trajectories and the trajectory ranges can beadjusted.

For exemplary purposes, a plurality of bone screw holes 76 a, 76 b, 76c, 76 d and K-wire holes 78 of various configurations are illustrated.The holes 76 a can be chamfered, cylindrical holes configured withthreads that threadingly engage respective bone screws and provide apredetermined trajectory. The holes 76 b can be chamfered, non-threadedcylindrical holes configured to receive respective bone screws andprovide predetermined trajectory ranges. The hole 76 c can be achamfered, non-threaded slot configured to receive a respective bonescrew at various positions longitudinal along the slot and provide apredetermined trajectory range. The hole 76 d can be a chamfered,non-threaded slot having an enlarged circular end. The enlarged circularend can be configured to allow the plate member 20 to be positioned overa respective bone screw previously threaded into the bone 16 andtranslated to bring the bone screw into engagement with the hole 76 d.The K-wire holes 78 can be chamfered, non-threaded cylindrical holesconfigured to receive respective K-wires.

The body 40 can be attached to a first portion of the bone 16 associatedwith one of the fragments 12, 14. According to the present example, thebody can be attached to the fragment 14. When the bone 16 is a longbone, such as in the present example, the body 40 can attach to adiaphyseal portion of the bone 16. The body 40 can include a portion ofthe bone engaging surface 32, a portion of the outer surface 34, and apredetermined number of the holes 24.

The body 40 can form the first contouring region 50 and can be sized toprovide the plate member 20 with a predetermined first stiffness in thefirst contouring region 50. For example, a thickness (z-direction) and awidth (y-direction) of the body 40 can be selected to provide the firstcontouring region 50 with the first stiffness. In variousimplementations, the body 40 can be relatively rigid when compared withthe first and second arms 42, 44 and the first and second tabs 46, 48.The thickness, the width, and the first stiffness can vary along thelength of the body 40. In the present example, the thickness graduallydecreases between a terminal end and an opposite end connected to thefirst and second arms 42, 44. The width gradually increases between theterminal end and the first and second arms 42, 44. Thus, the firststiffness in the z-direction gradually decreases between the terminalend and the first and second arms 42, 44.

The first arm 42 can extend from an end of the body 40 away from thecenter line 30 in a first transverse direction (e.g., y-direction and/orz-direction). The first arm 42 can extend at a predetermined angle θ1with respect to the center line 30 (FIG. 3). In various implementations,the first arm 42 can be curved and the angle θ1 can increase between thebody 40 and the first tab 46. In various implementations, the angle θ1can be between zero degrees and 90 degrees. More specifically, the angleθ1 can be between zero degrees and 45 degrees, and even morespecifically between zero degrees and 25 degrees.

The first arm 42 can extend between and can connect the body 40 and thefirst tab 46. The first arm 42 can engage a portion of the bone 16. Thefirst arm 42 can engage the support member 22 via the first recess 60and the first bottom surface 62. The first arm 42 can include a portionof the bone engaging surface 32 and a portion of the outer surface 34.Although not shown, the first arm 42 can include a predetermined numberof the holes 24.

The first arm 42 can form the second contouring region 52 a and can besized to provide the plate member 20 with a predetermined secondstiffness in the second contouring region 52 a. A thickness, a width,and the second stiffness can vary along a length of the first arm 42. Inthe present example, the thickness, in general, gradually decreasesbetween the body 40 and the first tab 46 and the width is generallyconstant along the length. Accordingly, the second stiffness graduallydecreases between the body 40 and the first tab 46. The first arm 42 canhave a predetermined length selected based on the particular bone towhich the plate member 20 is to be attached and the associated fracturepatterns. The length of the first arm 42 can be the same as or differentfrom the length of the body 40.

The second arm 44 can extend from the end of the body 40 away from thecenter line 30 in a second transverse direction. The second arm 44 canextend at a predetermined angle θ2 with respect to the center line 30(FIG. 3). In various implementations, the second arm 44 can be curvedand the angle θ2 can increase between the body 40 and the second tab 48.In various implementations, the angle θ2 can be between zero degrees and90 degrees. More specifically, the angle θ2 can be between zero degreesand 45 degrees, and even more specifically between zero degrees and 25degrees.

The second arm 44 can extend between and can connect the body 40 and thesecond tab 48. The second arm 44 can engage a portion of the bone 16.The second arm 44 can engage the support member 22 via the second recess64 and the second bottom surface 66. The second arm 44 can include aportion of the bone engaging surface 32 and a portion of the outersurface 34. Although not shown, the second arm 44 can include apredetermined number of the holes 24.

The second arm 44 can form the third contouring region 52 b and can besized to provide the plate member 20 with a predetermined thirdstiffness in the third contouring region 52 b. A thickness, a width, andthe third stiffness can vary along a length of the second arm 44. In thepresent example, the thickness, in general, gradually decreases betweenthe body 40 and the second tab 48 and the width is generally constantalong the length. Accordingly, the third stiffness in the z-directiongradually decreases between the body 40 and the first tab 46. The secondarm 44 can have a predetermined length selected based on the particularbone to which the plate member 20 is to be attached and the associatedfracture patterns. The length of the second arm 44 can be the same as ordifferent from the length of the first arm 42 and the length of the body40.

The first tab 46 can extend from an end of the first arm 42 opposite thebody 40, and can extend transverse to the first arm 42. The first tab 46can extend at a predetermined angle θ3 with respect to the center line30 (FIG. 4). In various implementations, the angle θ3 can be betweenzero degrees and 90 degrees. More specifically, the angle θ3 can bebetween zero degrees and 45 degrees, and even more specifically betweenzero degrees and 25 degrees. The angle θ3 can be varied throughre-contouring of the first tab 46.

The first tab 46 can extend towards or away from the center line 30. Thefirst tab 46 can be attached to a second portion of the bone 16associated with one of the fragments 12, 14. Depending on the fracturepattern, the first tab 46 can be attached to the same or a differentfragment than the fragment to which the body 40 is attached. Accordingto the present example, the first tab 46 can be attached to the samefragment 14 as the body 40. When the bone to which the plate member 20is to be secured is a long bone, the first tab 46 can be attached to anepiphyseal portion of the bone.

The first tab 46 can include a portion of the bone engaging surface 32,a portion of the outer surface 34, and a predetermined number of theholes 24. The number and arrangement of the holes 24 can be based on thetypical fracture patterns of the bone 16. The first tab 46 can form thefourth contouring region 54 a and can be sized to provide the platemember 20 with a predetermined fourth stiffness in the fourth contouringregion 54 a. The first tab 46 can have a predetermined width(y-direction) selected based on the particular bone to which the platemember 20 is to be attached and the associated fracture patterns.

The second tab 48 can be separated from the first tab 46 by a gap 79.The second tab 48 can extend from an end of the second arm 44 oppositethe body 40, and can extend transverse to the second arm 44. The secondtab 48 can extend at a predetermined angle with respect to the centerline 30. In the present example, the second tab 48 can extend at thesame angle θ3 as the first tab 46. In various implementations, the anglecan be between zero degrees and 90 degrees. More specifically, the anglecan be between zero degrees and 45 degrees, and even more specificallybetween zero degrees and 25 degrees. The angle can be varied throughre-contouring of the second tab 48.

The second tab 48 can extend towards or away from the center line 30.The second tab 48 can extend substantially parallel to the first tab 46.The second tab 48 can be attached to a third portion of the bone 16associated with one of the fragments 12, 14. Depending on the fracturepattern, the second tab 48 can be attached to the same or differentfragments than the fragment to which the body 40 is attached and thefragment to which the first tab 46 is attached. According to the presentexample, the second tab 48 can be attached to a different fragment, thefragment 12, than the fragment 14 to which the body 40 and the first tab46 is attached. When the bone to which the plate member 20 is to beattached is a long bone, the second tab 48 can attach to the epiphysealportion of the bone.

The second tab 48 can include a portion of the bone engaging surface 32,a portion of the outer surface 34, and a predetermined number of theholes 24. The number and arrangement of the holes 24 can be based on thetypical fracture patterns of the bone 16 and, thus, can be differentthan the number and arrangement of the holes 24 of the first tab 46. Thesecond tab 48 can form the fifth contouring region 54 b and can be sizedto provide the plate member 20 with a predetermined fifth stiffness inthe fifth contouring region. The second tab 48 can have a predeterminedwidth (y-direction) selected based on the particular bone to which theplate member 20 is to be attached and the associated fracture patterns.The width of the second tab 48 can be the same as or different from thewidth of the first tab 46.

The support member 22 can generally be smooth and thin and can have awidth (y-direction) that enables the support member 22 to span theaperture 36, and at opposite ends, to engage the plate member 20. Thesupport member 22 can be formed to have a pre-contoured shape based onthe morphology of the bone to which the support member 22 is to besecured and the pre-contoured shape of the plate member 20. The supportmember 22 can generally have a curved or arcuate shape as shown (FIG.5). When engaged, the outer surface 72 can be flush or nearly flush withan adjoining portion of the outer surface 34 of the plate member.

The support member 22 can include a sixth contouring region 80 having apredetermined sixth stiffness. A length (x-direction) and a thickness(z-direction) of the support member 22 along the width can vary. Thelength and the thickness can be selected to provide the support member22 with the sixth stiffness. In the present example, the length and thethickness can be generally constant along the width.

The support member 22 can include a predetermined number and arrangementof the holes 24. According to the present example, the support member 22can include three bone screw holes 76 spaced apart along a center lineof the support member 22. The support member 22 can further includeportions of the first and second engagement members 26, 28.

The first engagement member 26 can be disposed at a first interfacebetween the plate member 20 and the end of the support member 22received by the first recess 60. The first engagement member 26 caninclude a first bearing or engaging component 90 and a second bearing orengaging component 92. The first bearing component 90 can be coupled tothe plate member 20 and the second bearing component 92 can be coupledto the support member 22. The first and second bearing components 90, 92can be coupled in any suitable manner. The first bearing component 90can be formed integral with the plate member 20, as illustrated by thepresent example. Similarly, the second bearing component 92 can beformed integral with the support member 22.

The first bearing component 90 can directly engage the second bearingcomponent 92 when the support member 22 is engaged with the plate member20. When engaged, the first bearing component 90 can receive the secondbearing component 92. The first and second bearing components 90, 92 cancooperate and thereby constrain relative translational movement betweenthe first and second bearing components 90, 92 in at least onedirection. According to the present example, the first bearing component90 can constrain relative movement in a first direction (x-direction)perpendicular to a second direction (z-direction) in which the first andsecond bearing components 90, 92 engage. The first bearing component 90can permit relative translational movement in a third direction(y-direction) perpendicular to both the first and second directions.

In various implementations, the first bearing component 90 can be afirst concavity defining a recess and the second bearing component 92can be a first convexity. In the present example, the first bearingcomponent 90 can be a slot formed by the bottom surface 62 having acurved bottom forming curved sidewalls of the slot. A length of the slot(y-direction) can be selected to permit a predetermined amount ofrelative translational movement. The second bearing component 92 can bea hemispherical convexity formed by the inner surface 74 to complementthe sidewalls.

The second engagement member 28 can be disposed at a second interfacebetween the plate member 20 and the end of the support member 22received by the second recess 64. The second engagement member 28 caninclude a third bearing or engaging component 94 and a fourth bearing orengaging component 96. The third bearing component 94 can be coupled tothe plate member 20 and the fourth bearing component 96 can be coupledto the support member 22. The first and second bearing components 90, 92can be coupled in any suitable manner and can be formed integral withthe plate member 20 and the support member 22, as illustrated by thepresent example.

The third bearing component 94 can directly engage the fourth bearingcomponent 96 when the support member 22 is engaged with the plate member20. When engaged, the third bearing component 94 can receive the fourthbearing component 96. The third and fourth bearing components 94, 96 cancooperate and thereby constrain relative translational movement betweenthe third and fourth bearing components 94, 96 in at least twodirections. According to the present example, the first and secondbearing components 94, 96 can constrain relative translational movementin a first direction (x-direction) perpendicular to a second direction(z-direction) in which the third and fourth bearing components 94, 96engage. The third and fourth bearing components 94, 96 can furtherconstrain relative translational movement in a third direction(y-direction) perpendicular to the first and second directions.

In various implementations, the third bearing component 94 can be asecond concavity defining a recess and the fourth bearing component 96can be a second convexity. In the present example, the third bearingcomponent 94 can be a hemispherical concavity formed by the bottomsurface 66. The fourth bearing component 96 can be a hemisphericalconvexity formed by the inner surface 74 to complement the third bearingcomponent 94. The third and fourth bearing components 94, 96 can form aball-and-socket-type joint.

With continued reference to FIGS. 1-5, a method for supporting afractured bone (e.g., bone 16) using the plate assembly 10 will now bedescribed. Generally, the method includes exposing the bone 16,selecting and selectively re-contouring the plate member 20 and thesupport member 22, engaging the plate member 20 and the support member22, and securing the plate member 20 and the support member 22 to thefragments 12, 14 of the bone 16. It will be appreciated that the bone 16can be exposed prior to or after selecting and/or re-contouring theplate member 20 and the support member 22. It will be furtherappreciated that the order of engaging the plate member 20 and thesupport member 22 and securing the plate member 20 and the supportmember 22 to the bone can vary.

The bone 16 can be exposed using a suitable surgical procedure. Theplate member 20 and the support member 22 can be individually selectedfor a particular patient from a group of pre-fabricated support members22 and plate members 20 provided in various sizes and pre-contouredshapes. As discussed above, the plate member 20 and the support member22 can have pre-contoured shapes designed to match the exterior shape ofthe bone 16. Additionally, the holes 24 formed in the plate member 20and the support member 22 can be configured to receive the variousattachment devices at predetermined trajectories. Due to variation inbone shape, the pre-contoured shapes of the selected components may notmatch the patient's bone as closely as desired. Due to variation infracture patterns, the predetermined trajectories of one or more of theholes 24 may not provide a desired trajectory for attachment with aparticular fragment of the fractured bone.

As desired, the selected plate member 20 and the support member 22 canbe independently re-contoured to more closely match the patient's boneand adjust the trajectories allowed by the holes 24. More specifically,the body 40, the first and second arms 42, 44, the first and second tabs46, 48, and the support member 22 can be independently re-contoured asdesired. Re-contouring can be performed in the various re-contouringregions 50, 52 a, 52 b, 54 a, 54 b, 80. Among the re-contouring regions50, 52 a, 52 b, 54 a, 54 b, 80, the stiffness can vary to facilitateindependent re-contouring. As one example, the fourth stiffness of thefirst tab 46 and the fifth stiffness of the second tab 48 can be lessthan the second stiffness of the first arm 42 and the third stiffness ofthe second arm 44. Additionally, the second and third stiffness of thefirst and second arms 42, 44 can be less than the first stiffness of thebody 40.

Re-contouring can be performed by bending and/or twisting the platemember 20 and the support member 22 using one or more bending tools. Forexample, the first and second arms 42, 44 can be independently bentabout the y-axis and/or twisted about the x-axis. The first and secondtabs 46, 48 can be bent about the x-axis and y-axis and can be twistedabout the y-axis. It will be appreciated that independent re-contouringrelative to one or more of the x-axis, the y-axis, and the z-axis can beperformed as desired. The bending tools can engage various surfaces andfeatures of the plate member 20 and the support member 22. For example,the bending tools can engage the bone engaging surface 32 and the outersurface 34 of the plate member 20, and/or can engage the outer and innersurfaces 72, 74 of the support member 22. The bending tools can alsoengage one or more of the holes 24 during re-contouring.

Once re-contoured to the desired shape, the plate member 20 can besecured to one or both the fragments 12, 14 of the bone 16 using thebone screws 18. While two bone fragments 12, 14 are shown for exemplarypurposes, additional bone fragments may be present. The plate member 20can be secured to one or more of the additional bone fragments asdesired. Subsequently, the re-contoured support member 22 can bedisposed on and brought into engagement with the plate member 20 via thefirst and second engagement members 26, 28. Once engaged, the supportmember 22 can be secured to one or both the fragments 12, 14 of the bone16 using the bone screws 18. Alternately, the support member 22 can bebrought into engagement while securing the support member 22 to one orboth the fragments 12, 14 using the bone screws 18.

In an exemplary sequence according to the present example, the body 40and the second tab 48 can be attached to the fragment 14 in that order.When attaching the body 40, the slotted hole 76 d can be used first tosecure the plate member 20 in a desired longitudinal position along thebone 16. Subsequently, one or more of the holes 76 a, 76 b, 76 d can beused to attach the plate member 20 to the fragment 14. Next, the supportmember 22 can be attached to the fragment 14. Subsequently, the firsttab 46 can be attached to the fragment 12.

With reference to FIGS. 6-9, another exemplary orthopedic plate assembly100 for internal fixation of two or more fragments of a fractured boneis presented. For clarity, various features of the plate assembly 100will be described with reference to coordinate axes shown in FIG. 6. Theplate assembly 100 can be configured to attach to the distal, volaraspect of a fractured radius in a similar manner as the plate assembly10. Generally, the plate assembly 100 can include a bifurcated platemember 102, a support member 104, a first engagement member 106, asecond engagement member 108, and a plurality of holes 110 for receivingsuitable attachment devices (e.g., bone screws 18).

The plate member 102 can have a length along a center line 112 and caninclude a bone engaging surface 114, an outer surface 116, an aperture118, and a predetermined number of the holes 110. In FIGS. 6-9, thecenter line 112 is shown to extend along the x-axis. The bone engagingsurface 114 and the outer surface 116 can be substantially similar tothe bone engaging surface 32 and the outer surface 34 of the plateassembly 10. When formed, the plate member 102 can have a pre-contouredshape based on the typical morphology of the bone (e.g., bone 16) towhich the plate member 102 is to be secured. The holes 110 can besubstantially similar to the holes 24 and can have a predeterminedarrangement selected in a manner similar the holes 24.

The plate member 102 can further include a body 120, a first arm 122, asecond arm 124, a first tab 126, and a second tab 128. The body 120, thefirst and second arms 122, 124, and the first and second tabs 126, 128can be substantially similar to the body 40, first and second arms 42,44, and first and second tabs 46, 48. For brevity, the differencesbetween the plate member 102 and the plate member 20 will be describedin further detail.

The first tab 126 can be attached to the same or a different bonefragment than the body 120. The first tab 126 can include a first tabbody 130, one or more first extensions 132, and a predetermined numberand arrangement of the holes 110. The first tab body 130 can extend froman end of the first arm 122 opposite the body 120, and can extendtransverse to the first arm 122. The first tab body 130 can include aportion of the bone engaging surface 114 and a portion of the outersurface 116.

The first extensions 132 can extend from the first tab body 130 invarious transverse directions. For example, the first extensions 132 canextend parallel to the center line 112, parallel to the direction inwhich the first tab body 130 extends, and/or in oblique directions withrespect to the center line 112 and the first tab body 130. The number,arrangement, and orientation of the first extensions 132 can bepredetermined based on bone morphology and typical fracture patterns.According to the present example, the first tab 126 can include fourfirst extensions arranged as shown.

One or more of the first extensions 132 can be configured to attach tothe bone. According to the present example, each of the first extensions132 can include one of the holes 110 for attachment to the bone. Thefirst extensions 132 can form additional contouring regions that enableindependent re-contouring of the first extensions 132 to more closelymatch the bone and/or vary the trajectories of respective bone screws.The first extensions 132 can be sized to provide each of the associatedcontouring regions with a predetermined stiffness. Among the firstextensions 132, the stiffness can vary. In FIG. 7, exemplary boundariesof the additional contouring regions are illustrated by the dashedlines.

The second tab 128 can be attached to the same or a different bonefragment than the body 120 and/or the first tab 126. The second tab 128can include a second tab body 140, one or more second extensions 142,and a predetermined number of the holes 110. The second tab body 140 canextend from an end of the second arm 124 opposite the body 120, and canextend transverse to the second arm 124. The second tab body 140 caninclude a portion of the bone engaging surface 114 and a portion of theouter surface 116.

The second extensions 142 can extend from the second tab body 140 invarious transverse directions. The number, arrangement, and orientationof the second extensions 142 can be predetermined based on bonemorphology and typical fracture patterns. According to the presentexample, the second tab 128 can include three first extensions arrangedas shown. One or more of the second extensions 142 can be configured toattach to the bone. According to the present example, each of the secondextensions 142 can include one of the holes 110 for attachment to thebone. The second extensions 142 can form additional contouring regionsthat enable independent re-contouring of the second extensions 142 tomore closely match the bone and/or vary the trajectories of respectivebone screws. The second extensions 142 can be sized to provide each ofthe associated contouring regions with a predetermined stiffness. Amongthe second extensions 142, the stiffness can vary. In FIG. 7, theadditional contouring regions are illustrated by dashed lines.

The support member 104 can have a pre-contoured shape based on the bonemorphology and the pre-contoured shape of the plate member 102. Thesupport member 104 can include a support body 144, third extensions 146,and a predetermined number and arrangement of the holes 110. The supportbody 144 can have a width (y-direction) that enables the support body144 to span the aperture 118 and can include an inner surface 148 thatengages the plate member 102 at opposite ends of the support member 104.The inner surface 148 can include shoulders and can extend within theaperture 118 between the bone engaging surface 114 and the outer surface116 as shown (FIG. 9).

The third extensions 146 can extend from the support body 144 in varioustransverse directions. The number, arrangement, and orientation of thethird extensions 146 can be predetermined based on bone morphology andtypical fracture patterns. One or more of the third extensions 146 canbe configured to attach to the bone. According to the present example,each of the third extensions 146 can include one of the holes 110 forattachment to the bone. The third extensions 146 can form additionalcontouring regions and can be sized to provide each of the associatedcontouring regions with a predetermined stiffness. Among the thirdextensions 146, the stiffness can vary. In FIG. 7, the additionalcontouring regions are illustrated by dashed lines.

The first engagement member 106 can be disposed at a first interfacebetween the plate member 102 at a first end of the support member 104.The first interface can be disposed at the first arm 122. The firstengagement member 106 can include a first bearing or engaging component150, a second bearing or engaging component 152, an elongated hole 154,a first threaded hole 156, and a first threaded fastener 158.

The first bearing component 150 can be disposed on a transverse surface160 of a first recess 162 formed in the outer surface 116 that receivesthe first end of the support member 104. The first recess 162 and thefirst bearing component 150 can be formed integral with the first arm122. The first bearing component 150 can include a convex, curved firstbearing surface that directly engages the second bearing component 152.Through re-contouring, the first bearing component 150 can engage thesecond bearing component 152 at various contact angles. Accordingly, thefirst bearing surface can be curved to provide a suitable contactsurface between the first and second bearing components 150, 152 over apredetermined range of contact angles.

The second bearing component 152 can be disposed at the first end of thesupport body 144 on the inner surface 148. The second bearing component152 can be formed integral with the support body 144. The second bearingcomponent 152 can include a generally flat, second bearing surface thatdirectly engages the first bearing component 150. Alternately, thesecond bearing surface can be a concave, curved surface complementarywith the first bearing surface.

The elongated hole 154 can be formed in and extend along the width ofthe support body 144 at the first end. The elongated hole 154 can beconfigured to receive the first threaded fastener 158 at various anglescorresponding to the predetermined range of contact angles between thefirst and second bearing components 150, 152. For example, the elongatedhole 154 can be chamfered and can be sized larger than a threadedportion of the first threaded fastener 158. The chamfer of the elongatedhole 154 can be sized to constrain translational movement of the firstthreaded fastener 158 in a first direction (x-direction). The elongatedhole 154 can have a predetermined width (y-direction) for receiving thefirst threaded fastener 158 at various positions along the width.

The first threaded hole 156 can be formed in and extend through thefirst bearing component 150. The first threaded hole 156 can beconfigured to threadingly engage the first threaded fastener 158. Thefirst threaded fastener 158 can be configured to engage the elongatedhole 154 and threadingly engage the first threaded hole 156.

The second engagement member 108 can be disposed at a second interfacebetween the plate member 102 at a second end of the support member 104opposite the first end. The second interface can be disposed at thesecond arm 124. The second engagement member 108 can include a thirdbearing or engaging component 170, a fourth bearing or engagingcomponent 172, a circular hole 174, a second threaded hole 176, and asecond threaded fastener 178.

The third bearing component 170 can be disposed on a transverse surface180 of a second recess 182 formed in the outer surface 116 that receivesthe second end of the support member 104. The second recess 182 and thethird bearing component 170 can be formed integral with the second arm124. The third bearing component 170 can include a convex, curved thirdbearing surface that directly engages the fourth bearing component 172.Through re-contouring, the third bearing component 170 can engage thefourth bearing component 172 at various contact angles. Accordingly, thethird bearing surface can be curved to provide a suitable contactsurface between the third and fourth bearing components 170, 172 over apredetermined range of contact angles.

The fourth bearing component 172 can be disposed at the second end ofthe support body 144 on the inner surface 148. The fourth bearingcomponent 172 can be formed integral with the support body 144. Thefourth bearing component 172 can include a generally flat, fourthbearing surface that directly engages the third bearing component 170.Alternately, the fourth bearing surface can be a concave, curved surfacecomplementary with the third bearing surface.

The circular hole 174 can be formed in the support body 144 at thesecond end. The circular hole 174 can be configured to receive thesecond threaded fastener 178 at various angles. For example, thecircular hole 174 can be chamfered and can be sized larger than athreaded portion of the second threaded fastener 178. The chamfer of thecircular hole 174 can be sized to constrain translational movement ofthe second threaded fastener 178 in both a first direction (x-direction)and a second direction (y-direction) perpendicular to the firstdirection.

The second threaded hole 176 can be formed in and extend through thethird bearing component 170. The second threaded hole 176 can beconfigured to threadingly engage the second threaded fastener 178. Thesecond threaded fastener 178 can be configured to engage the circularhole 174 and threadingly engage the second threaded hole 176.

With continued reference to FIGS. 6-9, the plate assembly 100 can beused in a method for supporting a fractured bone that is substantiallysimilar to the procedure described above with reference to the plateassembly 10. The plate assembly 100 can be attached to the bone in asubstantially similar manner as the plate assembly 10. However, it willbe appreciated that the support member 104 can be attached to the platemember 102 without attaching the support member 104 to the bone via thethreaded fasteners 158, 178 of the first and second engagement members106, 108. When attached in this manner, the plate member 102 can beattached to various bone fragments and the support member 104 canprovide additional support for retaining the plate member 102 in adesired shape.

The plate assembly 100 can provide additional independent re-contouringcapability. The additional re-contouring capability can be provided viathe various first and second extensions 132, 142 provided with the platemember 102 and the various third extensions 146 provided with thesupport member 104. Each of the first, second, third extensions 132,142, 146 can be independently re-contoured to more closely match theunique shape of the patient's bone. Alternately or additionally, each ofthe first, second, third extensions 132, 142, 146 can be independentlyre-contoured to provide a desired trajectory for a bone screw 18 orother suitable attachment device.

With reference to FIG. 10, another exemplary orthopedic plate assembly200 for internal fixation of two or more fragments of a fractured boneis presented. The plate assembly 200 is substantially similar to theplate assembly 10, except that plate assembly 200 can receive a supportmember (e.g., support member 22) at various predetermined longitudinalpositions. Accordingly, for brevity, the differences between the plateassembly 200 and the plate assembly 10 will be described in furtherdetail. The plate assembly 200 can include a plate member 202 includinga first elongated slot 204 having a transversely extending first bottomsurface 206, and a second elongated slot 208 having a transverselyextending second bottom surface 210. The first and second elongatedslots 204, 208 can be configured to receive opposite ends of the supportmember at various predetermined longitudinal positions along a length ofthe plate member 202.

The plate member 202 can further include concavities 212 a, 212 b, 212 cand pairs of slots 214 a, 214 b, 214 c for engagement with the supportmember. The concavities 212 a, 212 b, 212 c can be substantially similarto the third bearing component 94 of the plate member 20. The slots 214a, 214 b, and 214 c can be substantially similar to the first bearingcomponent 90 of the plate member 20.

The concavities 212 a, 212 b, 212 c and the pairs of slots 214 a, 214 b,214 c can be arranged to allow the support member to engage the platemember 202 using various combinations of the concavities 212 a, 212 b,212 c and the pairs of slots 214 a, 214 b, 214 c. In an exemplaryarrangement, the support member can engage the plate member 202 atvarious longitudinal positions and orientations as illustrated by dashedlines P₁, P₂, P₃ and dashed lines P₁′, P₂′, P₃′. Accordingly, it will beappreciated that the plate member 202 can be configured to receive thesupport member at various longitudinal positions and at varioustransverse angles.

The foregoing description of the examples has been provided for purposesof illustration and description. It is not intended to be exhaustive orto limit the present teachings. Individual elements or features of aparticular example are generally not limited to that particular example,but, where applicable, are interchangeable and can be used in a selectedexample, even if not specifically shown or described. The same may alsobe varied in many ways. Such variations are not to be regarded as adeparture from the present teachings, and all such modifications areintended to be included within the scope of the present teachings.

1. An orthopedic plate assembly for supporting a bone, comprising: ay-shaped first plate attachable to the bone and having a center line,the first plate including an elongate body attachable to a first portionof the bone and extending along the center line, a first armtransversely extending from an end of the body, and a second armtransversely extending from the end of the body, the first and secondarms defining an aperture in the first plate; and a second plateseparate from the first plate and attachable to the bone, the secondplate having a first end configured to be disposed on and engaged withthe first arm, and a second end opposite the first end configured to bedisposed on and engaged with the second arm, the second plate configuredto span the aperture transverse to the center line when engaged with thefirst and second arms.
 2. The orthopedic plate assembly of claim 1,wherein the second plate is configured to engage the first arm in acentral region of the first arm between the body and an end of the firstarm opposite the body, and to engage the second arm in a central regionof the second arm between the body and an end of the second arm oppositethe body.
 3. The orthopedic plate assembly of claim 1, wherein the firstplate includes a first major surface engageable with the bone and asecond major surface opposite the first major surface, and wherein thesecond plate is received within a first recess formed in the secondmajor surface and disposed on the first arm, and a second recess formedin the second major surface and disposed on the second arm.
 4. Theorthopedic plate assembly of claim 1, wherein the first plate furtherincludes a first tab extending from an end of the first arm opposite thebody in a first direction transverse to the center line; and a secondtab extending from an end of the second arm opposite the body in asecond direction transverse to the center line, and wherein the firstand second tabs are separated by a gap, and at least one of the firsttab and the second tab is attachable to the bone.
 5. The orthopedicplate assembly of claim 4, wherein the second plate is configured toengage the first arm between the body and the first tab, and to engagethe second arm between the body and the second tab.
 6. The orthopedicplate assembly of claim 4, wherein the first tab includes an extensionthat extends from the first tab in a third direction transverse to thefirst direction in which the first tab extends.
 7. The orthopedic plateassembly of claim 4, wherein a predetermined first stiffness of thefirst tab is less than a predetermined second stiffness of the firstarm, and wherein the predetermined second stiffness is less than apredetermined third stiffness of the body.
 8. The orthopedic plateassembly of claim 1, wherein the second plate includes an extension thatextends from the second plate in a first direction transverse to asecond direction between the first and second ends of the second plate.9. The orthopedic plate assembly of claim 1, further comprising a firstbearing component coupled to the first arm; and a second bearingcomponent coupled to a first end of the second plate, wherein the firstand second bearing components cooperate and thereby constrain relativetranslational movement between the first plate and the second plate inat least two perpendicular directions when the second plate is engagedwith the first plate.
 10. The orthopedic plate assembly of claim 9,wherein the first and second bearing components are configured to form aball-and-socket-type joint.
 11. The orthopedic plate assembly of claim9, further comprising a third bearing component coupled to the secondarm; and a fourth bearing component coupled to a second end of thesecond plate, wherein the third and fourth bearing components cooperateand thereby constrain relative translational movement between the firstplate and the second plate in a single direction only when the secondplate is engaged with the first plate.
 12. The orthopedic plate assemblyof claim 9, further comprising a third bearing component coupled to thefirst arm and longitudinally spaced apart from the first bearingcomponent, wherein the third bearing component is configured tocooperate with the second bearing component and thereby constrainrelative translational movement between the first plate and the secondplate in at least two perpendicular directions.
 13. An orthopedic plateassembly for supporting a fractured radius, comprising: a first plateattachable to a first bone fragment and a second bone fragment of theradius and having a center line, the first plate including an elongatebody attachable to the first fragment and extending along the centerline, a first arm transversely extending from an end of the body, and asecond arm transversely extending from the end of the body, the firstand second arms defining an aperture in the first plate; a second plateseparate from the first plate, the second plate including a firsttransverse surface on a first end engageable with a second transversesurface of the first arm, and a third transverse surface on a second endopposite the first end engageable with a fourth transverse surface ofthe second arm; and a first engagement member configured to constrainrelative translational movement between the first and second plates inat least two perpendicular directions when engaged, the first engagementmember including a first bearing component coupled to the firsttransverse surface of the second plate, and a second bearing componentcoupled to the second transverse surface of the first arm and directlyengageable with the first bearing component, wherein the second plate isconfigured to span the aperture transverse to the center line whenengaged with the first and second arms.
 14. The orthopedic plateassembly of claim 13, wherein the second plate is attachable to at leastone of the first and second fragments.
 15. The orthopedic plate assemblyof claim 13, wherein the first and second bearing components form aball-and-socket-type joint when engaged.
 16. The orthopedic plateassembly of claim 13, wherein the first and second bearing componentsare configured to form a threaded connection between the first andsecond plates.
 17. The orthopedic plate assembly of claim 13, whereinthe first plate further includes a first tab extending from an end ofthe first arm opposite the body in a first direction transverse to thecenter line; and a second tab extending from an end of the second armopposite the body in a second direction transverse to the center line,and wherein the first and second tabs are separated by a gap and atleast one of the first tab and the second tab is attachable to at leastone of the first and second bone fragments.
 18. The orthopedic plateassembly of claim 17, wherein a predetermined first stiffness of thefirst tab is less than a predetermined second stiffness of the firstarm, and wherein the predetermined second stiffness is less than apredetermined third stiffness of the body.
 19. A method for supporting afractured radius using an orthopedic plate assembly, the methodcomprising: exposing the radius; selecting a first plate and selectivelyre-contouring the first plate, the first plate having a center line andincluding a body extending along the center line, a first armtransversely extending from an end of the body and including a firsttransverse surface, and a second arm transversely extending from the endof the body and including a second transverse surface, the first andsecond arms defining an aperture in the first plate; attaching the firstplate to a first portion of the radius using a first attachment device;selecting a second plate and selectively re-contouring the second plate,the second plate having a first end including a third transverse surfaceengageable with the first transverse surface of the first arm, and asecond end opposite the first end including a fourth transverse surfaceenagageable with the second transverse surface of the second arm;engaging the second plate with the first plate at a predeterminedlongitudinal position within the aperture by engaging the third andfourth transverse surfaces of the second plate with the first and secondtransverse surfaces of the second plate, respectively; and attaching thesecond plate to at least one of the first plate and a second portion ofthe radius.
 20. The method of claim 19, wherein the attaching the secondplate includes attaching the second plate to the second portion of theradius and compressing the first plate between the second plate and theradius.
 21. The method of claim 19, wherein the attaching the secondplate includes attaching the second plate to the second portion of theradius, and wherein the engaging the second plate with the first plateis performed during the attaching the second plate to the second portionof the radius.
 22. The method of claim 19, wherein after the engagingthe second plate with the first plate, the first and third transversesurfaces cooperate and thereby constrain relative translational movementbetween the first plate and the second plate in at least two directions.23. The method of claim 19, wherein the first plate is configured toengage the second plate at a plurality of predetermined longitudinalpositions and the method further comprises selecting one of thepredetermined longitudinal positions.
 24. The method of claim 19,wherein the attaching the first plate to the first portion of the radiusincludes attaching the first plate to a first bone fragment and a secondbone fragment.
 25. The method of claim 19, further comprisingdetermining a desired first size of the first plate based on the radius,and determining a desired second size of the second plate based on atleast one of the desired first size and the radius, wherein the firstplate is selected based on the desired first size and the second plateis selected based on the at least one of the desired first size and theradius.